Blog by W. Stephen Love, President/CEO, DFW Hospital Council

I recently read a fascinating article by the Kaiser Family Foundation analyzing uninsured adults in states not expanding Medicaid coverage as part of the Affordable Care Act (ACA). The ACA expanded Medicaid coverage to nearly all adults with incomes up to 138 percent of the Federal Poverty Level (FPL).

In examining the Kaiser fact sheet, some interesting facts stood out:
• In the U.S., only 14 states have not expanded Medicaid;
• If all states expanded Medicaid, 4.4 million uninsured non-elderly adults would be eligible for coverage (1.4 million live in Texas);
• Of the Texans eligible under Medicaid expansion, 67 percent are childless adults historically excluded from the program;
• In Texas, 80 percent of the uninsured who would become eligible are in a family with at least one person employed in the workplace;
• In Texas, more than half (54 percent) are adults living below the FPL;
• In Texas, 758,000 women (more than 50 percent), are uninsured adults who would be eligible if Texas expanded coverage;
• Across the 14 non-expansion states, 50 percent of uninsured adults who would qualify are middle-aged and more likely to have substantial health needs.

Research shows states that expanded Medicaid provided increased coverage, improved affordability, reduced medical debt and decreased uncompensated care costs.

One fact we should examine is our traditional Medicaid federal share payment is approximately 61 percent of the total and the ACA Medicaid expansion federal share payment is 90 percent. This is a significant difference.

With our 86th legislative session winding down, we thank our leaders for their public service. Regardless of differing viewpoints, please remember Texas public health policy should benefit all Texans. When the 2021 session convenes, please give serious consideration to helping our vulnerable Texans by expanding our Medicaid coverage.

We need to enhance Medicaid coverage because the Delivery System Reform Incentive Payments (DSRIP) will be expiring under the current Medicaid 1115 Waiver, and many of the participants are not eligible for traditional Medicaid. Thus, without Medicaid expansion, these individuals will be left with no coverage.